Organization Name: | ROBERT G PATRUS DPM P.C. |
NPI Number: | 1164855490 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | ROBERT G PATRUS (DOCTOR) |
Mailing Address: | 22480 Kelly Rd Suite 103 Eastpointe |
State: | MI US |
Postal Code: | 480212623 |
Phone Number: | 5867751910 |
Fax Number: | 5867758387 |
NPI Enumeration Date: | 08/09/2013 |
NPI Last Update Date: | 05/06/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP1100X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Podiatric |
Taxonomy Definition: |